Prevalence of malocclusion in school going children of age 12-15 years in Telangana

Introduction

Health is the functional or metabolic regulation of a living body. In humans, health is an individual capability to conform and adjust to the challenges like socially, mental or physically.1

Health systems of the human body connects with oral health. Mouth is the window to health of our body. Most of the nutritional deficiencies, systemic diseases, infections etc are manifested first as oral conditions. Malocclusion is the highest public health problem in the world because of its high prevalence. It is one of the most common oral health problem after dental caries2 and periodontal diseases and it is ranked 3^rd among worldwide public health diseases. The WHO included malocclusion as handicapping dentofacial anomaly because it causes disfigurement or it impedes function.3 Since malocclusion has major affect on patients facial aesthetics, social and psychological consequences and bring the cause of stress for patient and their families.4 Therefore, it is important to find out the prevalence of malocclusion and proper treatment to correct them. One of the major problems in studying malocclusion is the availability of suitable method for recording the occurrence and severity of orthodontic problem thus orthodontic indices are used in epidemiological studies on malocclusion. Though malocclusion is a common oral health problem its diagnosis is dependent on classification of malocclusion. A standard system of classification for malocclusion is required for planning and evaluating the orthodontic services.5 One of the methods is by using orthodontic indices. An index has defined as a numerical value describing the relative status of a population on a graduated scale with definite upper and lower limits.6

The results of the epidemiological studies in India on malocclusion not only helps in planning orthodontic treatment but also helps in rational approach for determining the etiological factors of malocclusion.7 Telangana – Suma S et al.8 in his study compared the prevalence and severity of malocclusion between rural and urban children in nalgonda district. They observed that the malocclusion was more in urban (20.8%) than in rural areas (14.9%) and more in females (21.8%) than males (13.2%) the reason was socio-economical variation and dietary habits. G Anita et al.9 conducted a study on school students in Telangana state, they observed 10% requires elective treatment, 3% suggesting highly desirable treatment and 0.9% indicating mandatory treatment, 86.1% suggesting no treatment. Venugopal reddy et al.10 has done a study on schoolgoing children of Khammam district of age group 10-12 years. He observed that 65.9% with class I malocclusion, 9.25% has class II malocclusion and 1.37% has class III malocclusion, 15.4% has increased overjet, 0.2% has reverse overjet, 43.6% has increased overbite, 2% have Openbite, 14.01% had cross bite, 46.23% has midline diastema and 2.98% had rotated tooth.

Materials and Methods

Figure 1

Flow chart of the methodology

Results

The frequency distribution of the collected study sample according to the groups, In total 9275 subjects, 2288 (24.7%) were with Class I molar relationship and without any dental positive findings. 5338 (57.6%) were with Class I malocclusion, 1386 (14.9%) were with class II malocclusion and 263 (2.8%) were with Class III malocclusion (Table 1).

Discussion

Epidemiological study of disease is the first step in public health endeavours. In India as mentioned in the introduction section there is wide variation in prevalence of malocclusion11 which can be attributed to lack of uniformity in collection of data, variability of methods, indices used to access the severity of malocclusion. The prevalence of malocclusion is found to vary with different population, race, origin and ethnicity.12

The overall prevalence of malocclusion of 12 to 15 years old children was found to be 89% in agreement with previous studies.13 Children at this age are permanent dentition which represents their health status. With age children grow and interact with various environments; they begin to develop differential self-concepts that are specific to different areas of life. This process begins in early childhood and accelerates during the higher primary and high school years. Self-concept represents a learned, organised response pattern that incorporates the reactions of other people; the positive and negative experiences of the child and the Childs ability to achieve his/her goals and objectives.14

It has shown that children begin to understand the ill health effects on social activities around eight years of age along with the enormous psychosocial changes associated with childhood.15 The time of middle adolescence represents when social relationships may be particularly important increasing from early adolescence and levelling off in late adolescence16, 17 Malocclusions with commonly occurring forms in adolescents are often presumed to be at the risk for negative self-esteem and social maladjustment. 18 Bullying is another social impact commonly attributed to malocclusion.19

With this background the present study was designed to assess the prevalence of malocclusion and need for orthodontic treatment in 12-15 years old Telangana school children, selecting three types of schools viz government, private, private aided schools with boys and girls. Many epidemiological studies have done previously among different populations, age groups, ethnic regions & minor communities to evaluate the prevalence of malocclusion, but there is evidence of limited documentation on newly divided regions of India after 2014 like Telangana state. Being a resident researcher of that region, this study has focused on the population of Telangana state.

One of the major hindrances to get uniform data related to prevalence of malocclusion in India is because of variable ethnic, linguistic, communal nativities. So, it is very difficult to screen the whole population of entire country to interpret the results for application. Moreover, selecting a specific population to access the prevalence is also difficult as variations are observed among the same set of population. Hence, we incorporated 9219 school children of 12-15 years age group residing in Telangana region. The primary objective of the assessment is to determine the prevalence of malocclusion & dental anomalies to estimate the treatment needs of a population as a basis for planning of orthodontic services. Recording malocclusion is important for document purpose which serves as data for planning orthodontic service to the community. Among various types of quantitative methods,16 WHO/FDI basic method is one such tool which provides a common morphology basis for studies of prevalence of malocclusion in various parts of the world as well as for studies into methods for assessing the need and demand for treatment of malocclusion. Table 1

The prevalence of Class I malocclusion with positive dental finding is found to be higher (57.6%) compared to Class II and Class III malocclusion. This can be attributed in accordance with study done by Sandhu S. S, 2012 as Class I malocclusion is the most prevalent malocclusion in India followed by Class II and Class III. The prevalence of Class II malocclusion (14.9%) is found to be higher than the average Class II malocclusion ion other parts of southern India where it is around (5%) [Sadhu S. S]. The prevalence of Class III malocclusion (2.8%) is also different from regions of India like 1.4% in Rajasthan 2.3% in Bangalore 3.4% in Delhi [Das U. M]. These finding are different from Caucasians (0.8%) and Chinese (4%) population.

Conclusion

Observations recorded from our study as follows:

This study gives a baseline data of the prevalence and severity of malocclusion in 12-15 years of school children in Telangana state.

Outcome of this study is useful to the community

Whereas, the limitations are,

Source of Funding

None.

Conflict of Interest

None.